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CHARACTERISTICS OF CLINICAL AND PARACLINICAL OF NON-SMALL CELL LUNG CANCER PATIENTS WITH EPIDERMAL GROWTH FACTOR RECEPTOR MUTANT AND BRAIN METASTASIS TREATED AT BACH MAI HOSPITAL
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Abstract
Object: Characterizing of non-small cell lung cancer patients with epidermal growth factor receptor mutant and brain metastasis treated at Bach Mai Hospital. Patient and Methods: Retrospective, descriptive, cross-sectional, studying on 53 epidermal growth factor receptor, brain metastasis of mutant non-small cell lung cancer patients treated with tyrosine kinase inhibitors plus Rotating Gamma System Radiosurgery at the Nuclear Medicine and Oncology Center of Bach Mai Hospital from January 2016 to December 2020. Results: 50.9% male, male/female ratio: 1.04/1, mainly aged 50-69 (73.6%). 43.4% of patients smoked, only found in men. Common symptoms were respiratory symptoms (54.7%), followed by neurological symptoms (39.6%). Most of the patients had a PS ECOG score from 0 to 1 (81.1%). Stage T1-2 saw 64.2%, lymph node metastasis (58.5%), brain metastases often combined with other organs (64.2%) of which bone metastases most commonly (49.1%), followed by metastases in lung, pleura (28.3%), adrenal gland (5.7%), liver (3.7%). Characteristics of brain metastases: Single-focal metastasis occurred in 47%, the location or metastasis was in the cerebral hemisphere (79.2%), size from 1-20mm accounted for the highest rate (69.9%), small size 1-10mm accounted for 20.1%. The majority of patients with Del19 mutant (67.9%), Del 19/L858R = 2.77/1. Compared with the exon 21 mutation, the Del 19 mutation was more common in the female group (63.9%) the difference was statistically significant with p=0.005. Most of the patients had abnormal CEA, cyfra 21-1 concentration (81.8% and 70.3%). Bone metastasis was closely associated with abnormally elevated CEA with p=0.047. Conclusion: non-small cell lung cancer patients with epidermal growth factor receptor mutant and brain metastasis had a balanced male/female ratio, Del 19 mutations were the majority and more common in women than men. CEA has high sensitivity in predicting systemic metastases, especially bone metastases.
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Keywords
brain metastasis, lung cancer, EGFR mutation, patient characteristics, CEA
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